Annex C

CHECKLIST OF REQUIREMENTS

Name of Applicant: JACKY D. JUMAO-AS

Position Applied For: TEACHER 1
Course: BSED MAJOR IN MATHEMATICS
Contact Number: 09933894727
Religion: ROMAN CATHOLIC
Person with Disability: Yes ( ) No ( ) Specify (if Yes ):________________________________
Solo Parent: Yes ( ) No ( )
Status of Verification
Submission (To be filled-out by the HRMO/HR
(To be filled-out Office/sub-committee)
Basic Documentary Requirement by the applicant.
Check if submitted)
Status of
Submission Remarks
(Check if complied)
Letter of intent addressed to the Head of Office, or to the highest human resource
officer designated by the Head of Office

CASIANA P. CABERTE, PhD, CESO VI

a. Assistant Schools Division Superintendent
Officer-in-Charge
Office of the Schools Division Superintendent
DepEd, Division of Bohol
Duly accomplished Personal Data Sheet (PDS)
b. (CS Form No. 212, Revised 2017) with latest 2x2 ID picture and Work Experience
Sheet, if applicable
c. Valid and updated PRC License/ID, if applicable
d. Certificate of Eligibility/Report of Rating, if applicable
Scholastic/academic record such as but not limited to Transcript of Records
e. (TOR) and Diploma, including completion of graduate and post-graduate
units/degrees, if available
f. Certificate/s of Training, if applicable
Certificate of Employment, Contract of Service, or duly signed Service Record,
g. whichever is/are applicable
h. Latest appointment, if applicable
Performance Ratings in the last rating period(s) covering one (1) year
i. performance prior to the assessment, if applicable
Checklist of Requirements and Omnibus Sworn Statement on the Certification
j. on the Authenticity and Veracity (CAV) of the documents submitted and Data
Privacy Consent Form (Annex C)
k. Other documents as may be required for comparative assessment:
Means of Verification (MOVs) showing Outstanding Accomplishments,
l. Application of Education, and Application of Learning and Development
reckoned from the date of last issuance of appointment
Performance Rating obtained from the relevant work experience, if performance
m. rating in Item (i) is not relevant to the position to be filled

Attested:

______________________________________________________________
Human Resource Management Officer

OMNIBUS SWORN STATEMENT

CERTIFICATION OF AUTHENTICITY AND VERCITY

I hereby certify that all information above are true and correct, and of my personal knowledge and belief, and the documents submitted herewith
are original and/or certified true copies thereof.

DATA PRIVACY CONSENT

I hereby grant the Department of Education the right to collect and process my personal information as stated above, for purposes relevant to the
recruitment, selection, and placement of personnel of the Department and for purposes of compliance with the laws, rules, and regulations being
implemented by the Civil Service Commission.

JACKY D. JUMAO-AS
Name and Signature of Applicant

Subscribed and sworn to before me this ________ day of __________________________, year __________.

Person Administering the Oath